Bottom Line:
However, 34.5% (166 of 481) of the patients did not show any evidence of detrusor muscle in their biopsy specimen.The incidence of smoking was much higher among males compared with females (74% vs. 22%).Younger-aged patients have low-grade disease.

Purpose: To determine the impact of age and gender on the clinicopathological characteristics of histologically confirmed bladder cancer in India.

Materials and methods: From January 2001 to June 2008, records of patients with bladder cancer were evaluated for age and gender at presentation, clinical symptoms, cystoscopic finding, history of smoking, and histopathological characteristics. A total of 561 patients were identified from the computer-based hospital information system and the case files of patients.

Results: A total of 97% of the patients presented with painless hematuria. The mean age was 60.2 +/- 4.4 years old (range: 18-90 years old) and the male to female ratio was 8.6:1. Transitional cell carcinoma (TCC) was the most common histological variety, which was present in 97.71% (470 of 481) of the patients. A total of 26% of the patients had muscle invasive disease at the time of presentation. However, 34.5% (166 of 481) of the patients did not show any evidence of detrusor muscle in their biopsy specimen. In patients with nonmuscle-invasive bladder carcinoma, 55% had p Ta while 45% had p T1. Overall, 44.7% (215 of 481) of the patients had low-grade disease. Among patients younger than 60 years old, low-grade (51.0% vs. 38.1%; P = 0.006) and low-stage (77.1% vs. 70.8%; P = 0.119) disease were more prevalent than in patients older than 60 years old. The incidence of smoking was much higher among males compared with females (74% vs. 22%).

Conclusion: TCC is the predominant cancer, with significant male preponderance among Indian patients. Younger-aged patients have low-grade disease. Hematuria is the most common presentation and greater awareness is needed not to overlook bladder cancer.

Mentions:
The median age at presentation was 60 years old (range: 18–90 years old) and the average age was 60.2 ± 4.4 yrs. The age-wise pathological distribution of bladder tumors are shown in Table 1. Only 5.19% (25 of 481) of the patients presented with bladder cancer at younger than 40 years of age while only 2 patients presented with less than 20 years of age [Figure 1]. Low-grade cancer was found more commonly in patients younger than 60 years old as compared with patients older than 60 years old (51.0% vs. 38.1%; P-value = 0.006). Although not statistically significant, nonmuscle- invasive bladder tumors, i.e., Ta and T1 were relatively more common in the younger age group (41.6% vs. 39.0% and 35.5% vs. 31.8%, respectively) and muscle-invasive tumors were more common in the group of patients who were older than 60 years old (29.2% vs. 22.9%; P = 0.119). The male to female ratio was 8.6:1. A total of 74% of the males and 22% of the females with bladder cancer smoked or had an intake of tobacco in some form. The incidence of various cancer stages and grades was not statistically different among both the gender groups. The pathological distribution of bladder cancer in males and females is shown in Table 2.

Mentions:
The median age at presentation was 60 years old (range: 18–90 years old) and the average age was 60.2 ± 4.4 yrs. The age-wise pathological distribution of bladder tumors are shown in Table 1. Only 5.19% (25 of 481) of the patients presented with bladder cancer at younger than 40 years of age while only 2 patients presented with less than 20 years of age [Figure 1]. Low-grade cancer was found more commonly in patients younger than 60 years old as compared with patients older than 60 years old (51.0% vs. 38.1%; P-value = 0.006). Although not statistically significant, nonmuscle- invasive bladder tumors, i.e., Ta and T1 were relatively more common in the younger age group (41.6% vs. 39.0% and 35.5% vs. 31.8%, respectively) and muscle-invasive tumors were more common in the group of patients who were older than 60 years old (29.2% vs. 22.9%; P = 0.119). The male to female ratio was 8.6:1. A total of 74% of the males and 22% of the females with bladder cancer smoked or had an intake of tobacco in some form. The incidence of various cancer stages and grades was not statistically different among both the gender groups. The pathological distribution of bladder cancer in males and females is shown in Table 2.

Bottom Line:
However, 34.5% (166 of 481) of the patients did not show any evidence of detrusor muscle in their biopsy specimen.The incidence of smoking was much higher among males compared with females (74% vs. 22%).Younger-aged patients have low-grade disease.

Purpose: To determine the impact of age and gender on the clinicopathological characteristics of histologically confirmed bladder cancer in India.

Materials and methods: From January 2001 to June 2008, records of patients with bladder cancer were evaluated for age and gender at presentation, clinical symptoms, cystoscopic finding, history of smoking, and histopathological characteristics. A total of 561 patients were identified from the computer-based hospital information system and the case files of patients.

Results: A total of 97% of the patients presented with painless hematuria. The mean age was 60.2 +/- 4.4 years old (range: 18-90 years old) and the male to female ratio was 8.6:1. Transitional cell carcinoma (TCC) was the most common histological variety, which was present in 97.71% (470 of 481) of the patients. A total of 26% of the patients had muscle invasive disease at the time of presentation. However, 34.5% (166 of 481) of the patients did not show any evidence of detrusor muscle in their biopsy specimen. In patients with nonmuscle-invasive bladder carcinoma, 55% had p Ta while 45% had p T1. Overall, 44.7% (215 of 481) of the patients had low-grade disease. Among patients younger than 60 years old, low-grade (51.0% vs. 38.1%; P = 0.006) and low-stage (77.1% vs. 70.8%; P = 0.119) disease were more prevalent than in patients older than 60 years old. The incidence of smoking was much higher among males compared with females (74% vs. 22%).

Conclusion: TCC is the predominant cancer, with significant male preponderance among Indian patients. Younger-aged patients have low-grade disease. Hematuria is the most common presentation and greater awareness is needed not to overlook bladder cancer.